Compound or practice · Supplement
Kava
One of the few genuinely effective anxiety botanicals — shadowed by a real (if debated) liver-safety history.
- Overall grade
- Grade B
- Last revised
- 2
- graded outcomes
- 0
- references listed
A structured monograph in Prometheus's bundled library. Its grades are the monograph's own reading of the evidence, not a peer-reviewed review.
2 at grade B · 1 at grade C — 3 graded rows
What is known
Each outcome with its grade (how strong the evidence is, A to D), the size of the effect where the entry records one, and how often studies agree.
- AnxietyEvidence grade B
Meta-analytic vs placebo
Moderatemixed
- Liver injury (rare)Evidence grade C
Extract/cultivar dependent
Smallmixed
Conditions
How the entry reads its effect on diagnosed conditions: the direction first, then the grade. Never a substitute for the person who treats you.
- Anxiety ImprovesEvidence grade BShort-termGrade B
What is uncertain
Read off the same rows as above. Nothing here is added that the entry does not itself record.
- Thin evidence: Liver injury (rare) (grade C).
- Studies disagree: Anxiety (mixed agreement).
- Caution with Alcohol: Additive sedation and compounded liver stress.
- Caution with Benzodiazepines: Additive sedation — a coma case is reported.
Interactions
Documented pairings with supplements and medicines. A medicine on this list is a conversation for whoever prescribes it.
AlcoholCaution
Additive sedation and compounded liver stress.
BenzodiazepinesCaution
Additive sedation — a coma case is reported.
The evidence in words
What it is
Kava (Piper methysticum) is a Pacific-island root whose kavalactones produce calm and mild sedation, used for anxiety.
How it works
Kavalactones modulate GABA and other pathways, producing anxiolysis without the dependence profile of benzodiazepines.
What the evidence shows
Meta-analyses find kava meaningfully reduces anxiety versus placebo — strong for a botanical. The overriding issue is rare hepatotoxicity that prompted bans in some countries; water-based extracts of noble cultivars appear safer than the acetone/ethanol extracts implicated. Not to be combined with alcohol or other sedatives.
How to use it
Standardized to ~70–250 mg kavalactones/day, short-term, water-based noble-cultivar products.
Safety & interactions
Liver-toxicity risk (rare) — avoid with alcohol, hepatotoxic drugs, or existing liver disease; additive with sedatives. alcohol — Additive sedation and compounded liver stress. benzodiazepines — Additive sedation — a coma case is reported.
Bottom line
A genuinely effective short-term anxiety herb with a serious liver caveat. Use water-based noble kava, never with alcohol or sedatives, and not long-term.
How it is used
As the entry records it, from the studies it summarises. Not a recommendation for you — doses that suit a trial population may not suit you.
- Standard
- 70–250 mg kavalactones/day, water-based, short-term.
Related reading
Entries that share this one's tags or conditions.
- Kava for AnxietyEvidence grade B — Meta-analytic vs placeboEvidence grade B
- Kava for Liver injury (rare)Evidence grade C — Extract/cultivar dependentEvidence grade C
- Kava: dosage and how to take it70–250 mg kavalactones/day, water-based, short-term.Evidence grade B
- Kava: side effects, safety & interactionsLiver-toxicity risk (rare) — avoid with alcohol, hepatotoxic drugs, or existing liver disease; additive with sedatives.Evidence grade B
Sources
This entry lists no references of its own.
Last revised . A grade is this entry's reading of the evidence, not medical advice.